Shaped mass composition comprising exenatide

ABSTRACT

Embodiments of the invention provide shaped masses comprising one or more drugs such as proteins or polypeptides and methods for forming such shaped masses. One embodiment provides a shaped mass comprising a drug such as a protein or polypeptide having a biological activity in the body of a mammal. The shaped mass is formed by compression of a precursor material comprising the drug wherein an amount of biologically active drug in the mass is a preserved above a minimum level. Drugs which may be incorporated into the shaped mass may include one or more glucose regulating proteins such as insulin, incretins; and immunoglobulins such as TNF-inhibiting antibodies or interleukin neutralizing antibodies. Embodiments of the shaped mass may be incorporated into a tissue penetrating member which is inserted into the intestinal wall allowing for the oral delivery of proteins and peptides which would otherwise be degraded in the intestinal tract.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/714,146, filed May 15, 2015, now U.S. Pat. No. 10,220,076; whichclaims the benefit of U.S. Provisional Patent Application Nos.61/993,907, filed May 15, 2014; 62/156,105, filed May 1, 2015; and62/159,134, filed May 8, 2015; the full disclosures of which areincorporated herein by reference.

FIELD OF THE INVENTION

Embodiments described herein relate to pharmaceutical compositions andmethods of fabrication of pharmaceutical compositions comprising solidmasses comprising proteins and polypeptides. More specifically,embodiments described herein relate to pharmaceutical compositions andmethods of production of pharmaceutical compositions comprising solidshaped masses comprising proteins and/or polypeptides having abiological activity wherein at least a portion of the biologicalactivity of the protein or polypeptide is maintained after formation ofthe solid mass.

BACKGROUND

While there has been an increasing development of new drugs in recentyears for the treatment of a variety of diseases, many includingproteins, antibodies and peptides have limited application because theycannot be given readily formed into solid shapes for oral or other formof delivery and/or encapsulated. One challenge in this area is that theprocess of fabrication of a drug comprising a protein, peptide orantibody into tablet or other solid form can result in loss in thebioactivity of the drug due to disruption of the structure of theprotein from the fabrication process. This is due to the fact that manyproteins have complex internal structures that define their biologicalactivity. Disruption in the structure of a protein and/or polypeptidecan result in its deactivation or considerable decline of itsbioactivity. Such disruption can result from fabrications processes suchas molding, compression, milling, grinding or encapsulation or otherrelated process. What is needed is a method for forming bioactivecompounds such as proteins, antibodies and peptides into solid orsemi-solid shapes for oral or other form of delivery to a human or othermammal without significant loss of bioactivity of the compound.

BRIEF SUMMARY OF THE INVENTION

Various embodiments of the invention provide pharmaceutical compositionscomprising solid shaped masses including one more or more drugs andmethods of production of the shaped masses. The drug may comprise one ormore polypeptides or proteins such as various immunoglobulins. Manyembodiments provide methods for forming solid shaped masses comprisingone or more proteins or polypeptides where the shaped masses are formedby the shaping of a precursor material and where at least a portion ofthe biological activity of the protein or polypeptide in the shaped massis preserved after formation. In many embodiments, the shaping is doneby compression of the precursor material where the compressive forcesare selected to minimize degradation of the biological activity of theprotein or polypeptide. Other shaping methods are also contemplated.Typically, the precursor material will comprise a powder mixturecomprising the drug and one or more excipients. The precursor materialmay also comprise a liquid, slurry or paste. The excipients may includeone more of a lubricant, a binder, bulking agent, etc. The shaped massmay be in the form of a tablet, micro-tablet, pill or slug shape.According to one or more embodiments, the shaped masses produced usingembodiments of the formation process can have another property such asdensity or particle grain size (of the powder used to formulate theshaped mass) which is correlated to minimum level of bioactivity of theprotein or peptide. Also, that correlated property may be mayconsistently maintained within a selected range within a given lot ofshaped masses as well from lot to lot. Embodiments of the solid massesdescribed herein can be configured to be used in combination with anysuitable drug delivery system to be administered via any appropriateroute of administration for the condition to be treated. Such routes ofadministration can include without limitation, oral, sublingualparenteral, intravenous, intramuscular, intra-ventricular,intra-cardiac. For example, according to one embodiment, insulincontaining micro-tablets can be taken orally and delivered into thesmall intestine where the drug is delivered into the wall of the of thesmall intestine where the tablet(s) dissolves to release the drug intothe blood stream. In another embodiment, insulin containing microtablets can be injected or otherwise placed subcutaneously (e.g.intramuscularly) where they dissolve to release insulin into thebloodstream.

In one aspect, the invention provides pharmaceutical compositionscomprising solid shaped masses comprising a drug or other therapeuticagent having a biological activity in the body of a mammal wherein atleast a portion of the biological activity of the drug is maintainedafter formation from a precursor material such as powder. The biologicalactivity may be correlated to the structural integrity of the drug postformation (e.g. by correlating bioactivity assays to chemical assays),such that on a compositional level, a selected percentage of the drug(e.g., on a weight basis) is maintained post formation relative to thatin the precursor material. Typically, the shape will be formed by acompression process (e.g. compression molding), though other processesare also contemplated such as non compressive molding. The drug maycomprise a protein, peptide or antibody wherein the biological activityof the drug in the shaped mass is at least 70% to that prior tocompression and more preferably, at least 90% to that prior tocompression and still more preferably at least 95%. These numbers mayalso correspond to a weight percentage of the drug remaining in theshaped mass relative to that in the precursor material (e.g., bycorrelating biological activity assays to chemical assays for weightcomposition as described above). In these and related embodiments, theshaped mass can have a density in a range of about 1.00 and 1.15 mg/mm³and in more preferred embodiments, 1.02 and 1.06 mg/mm³. The shape willtypically comprise a pellet shape but may also have a tablet, conical,cylindrical, cube, sphere or other like shape.

According to various embodiments, in addition to the drug and otherexcipients, the shaped mass can be formed from a biodegradable materialthat is configured to dissolve or otherwise degrade in the wall of theintestine such as the small intestine (or another tissue site, e.g. anintramuscular site) so as to release the drug into the intestinal wallwhere it diffuses or otherwise is transported into the capillary bed ofthe intestinal wall and then is carried by the circulatory systemthroughout the body. The shaped mass may inserted or otherwiseincorporated into a structure, such as a tissue penetrating member thatis made from such a biodegradable material. The tissue penetratingmember being configured to be penetrate and be inserted into the wall ofthe small intestine (or other lumen in the GI tract) by the applicationof force on the tissue penetrating member. Suitable biodegradablematerials include various sugars such as maltose and sucrose, variouslactic acid polymers such as polyglycolic acid (PGA), polylactic acid(PLA); polyglycolic lactic acid (PGLA); various polyethylenes, variouscelluloses, such as HPMC (hydroxypropyl methyl cellulose), PVOH(polyvinyl alcohol), silicone rubber. and other biodegradable polymersknown in the art. The material and other properties of the degradablepolymer and shaped mass can be selected to produce selectable rates ofdegradation in the intestinal wall. According to one or more embodimentsthe rates of degradation can be selected to achieve variouspharmacokinetic parameters such as t_(max), C_(max), t½, etc. In onemore specific embodiments, the materials properties of the shaped masscan be selected so as to have the shaped mass degrade within theintestinal wall to achieve a C_(max) for the selected drug(s) in ashorter time period than a time period to achieve a C_(max) for anextravascularly injected dose of the drug.

In one embodiment, the drug in the shaped mass comprises a glucoseregulating protein such as insulin for the treatment of diabetes orother glucose regulation disorder. The insulin may be obtained from anysuitable source (e.g. human insulin and/or that generated usingrecombinant DNA methods). In another application, the drug comprises aglucose regulating protein such as an incretin (e.g., exenatide) for thetreatment of a glucose regulation disorder. In these and relatedembodiments the compression or other molding process is configured topreserve the biological activity of the insulin or incretin or otherglucose regulating protein so as to be able to allow the drug to treatdiabetes or other glucose regulation disorder once released into thebody of a patient.

Still other embodiments provide shaped masses and methods for theirfabrication wherein the drug or other therapeutic agent in the shapedmass comprises an antibody such as IgG or an antibody from the TNFinhibiting class of antibodies such as adalimumab (HUMIRA), infliximab(Remicade), certolizumab, pegol (Cimzia), golimumab (Simponi), oretanercept (Enbrel) wherein the biological activity of the anti-body ispreserved after formation of the shaped mass in amounts of about 70, 75,80, 85, 90 or 95% relative to that of a precursor material prior toformation.

Yet still other embodiments provide shaped masses and methods for theirfabrication methods wherein the drug comprises an interleukinneutralizing protein such as an antibody which binds to one more orinterleukins or their receptors wherein the biological activity of theanti-body is preserved after formation of the shaped mass in amounts of70, 75, 80, 85, 90 or 95% relative to that of a precursor material priorto formation. Such interleukins can include one more of interleukins1-36 (e.g. interleukin 1, interleukin 17a) and their respectiveanalogues and derivatives. The interleukin neutralizing proteins arealso referred to herein as IN proteins (and also as an interleukinbinding protein or IB-protein), the anti-interleukin antibodies arereferred to herein as AI-antibodies and antibodies to the interleukin-17family of antibodies as AI17-antibodies. The AI antibody or other INprotein is capable of neutralizing and/or inhibiting the biologiceffects of one more of interleukins 1-36 by preventing or diminishingthe ability of the selected interleukin from binding to a receptor forthat interleukin.

Such a neutralizing effect produced by a particular IB-protein can beachieved by selecting the IB-protein to either: 1) bind to the selectedinterleukin so as prevent or inhibit that interleukin from binding tothe receptor for that interleukin and in turn causing one or morebiological effects; or 2) bind to a receptor for that particularinterleukin so as to prevent the interleukin from activating thereceptor and causing the one or more biologic effects. For example,according to one embodiment, an antibody such as Secukinumab can beselected which binds to interleukin-17. According to other embodiments,an antibody such as Brodalumab can be selected which binds to thereceptor for interleukin 17. The inhibited biological effects resultingfrom use of one or more embodiments of shaped masses comprisingAI-antibodies or other IB-proteins can include one or more of thefollowing: Th1 modulation; Th2 modulation (Nakanishi K., et al. (2001)Cytokine and Growth Factor Rev. 12:53-72); Nk modulation; neutrophilmodulation; monocyte-macrophage lineage modulation; neutrophilmodulation; eosinophil modulation; B-cells modulation; cytokinemodulation; chemokine modulation; adhesion molecule modulation; and cellrecruitment modulation. Also, according to one or more embodiments, theAI-antibody or other IN-protein can be selected to inhibit the biologiceffects of a selected interleukin so as to treat a variety of autoimmuneand/or inflammatory conditions associated with the activity of theselected interleukin. In preferred embodiments, such conditions caninclude one more of rheumatoid arthritis, psoriasis including plaquepsoriasis, psoriatic arthritis, fibrosis, ulcerative colitis, Crohn'sdisease, inflammatory bowel disease, multiple sclerosis and ankylosingspondylitis.

The IN-protein incorporated into the shaped mass may be selected from animmunoglobulin molecule such as an antibody or functional variantsthereof known in the art, with such variants retaining thecharacteristic binding property of the interleukin binding protein. Theimmunoglobulin may correspond to a full-length antibodies or anantigen-binding portion thereof. Examples of specific immunoglobulinmolecules which may be used include but are not limited to an scFv(single chain variable fragment); a monoclonal antibody; a humanantibody; a chimeric antibody; a humanized antibody; a single domainantibody; a Fab fragment; an Fab′ fragment; an F(ab′)2; an Fv (variablefragment); a disulfide linked Fv, and a bi-specific or dual specificantibody. Most preferably, the binding protein is a human antibody.

In many embodiments the dose of the selected AI-antibody, AI-17 antibodyor other IN-protein formulated into and/or as the shaped mass can betitrated to treat a selected condition described herein (e.g. psoriasis,rheumatoid arthritis, etc.), while minimizing the adverse effectassociated with an injected dose (e.g. intravenous, intramuscular,subcutaneous etc.) of the antibody. Such adverse effects can includewithout limitation one or more of anaphylactic shock or other allergicreaction (e.g., edema, water eyes, respiratory congestion), immunogenicreaction to the IN-protein (including immunogenic neutralization of thedelivered IN-protein by patients own antibodies), headache, fever andother related effect. In particular embodiments, this can be achieved bytitrating the delivered dose of AI-antibody or other IN-protein to adaily vs a monthly dose which is typically given for AI-antibodies suchas that for Secukinumab, Brodalumab or Ixekizumab. For the case ofminimizing immune response, this result can also be achieved bydelivering the dose of AI-antibodies to the upper or mid portion of thesmall intestine and avoiding the lower section of the intestine e.g.,the ileum containing the Peyer's patches as is discussed in furtherdetail herein. Other benefits of delivering the AI-antibody in smallerdoses into the small intestine (vs by injection) include one or more ofi) higher therapeutic ratios; and ii) reduced fluctuation in the plasmaconcentration for the AI-antibody or other IN protein.

Still other embodiments provide methods of preparing a shaped masscomprising a drug wherein an outer coating or layer is formed over thedrug using 3-D printing methods so as to produce a selectively shapedmass. Use of 3-D printing methods allow the shaped mass to be formedwithout the application of pressure on the mass. In use, such methodsimprove the yield of the drug in the final shaped mass due to decreasedprotein denaturation and/or other degradative effects on the drug. Thisin turn improves the bioactivity of the drug in the final shaped mass.Use of 3-D printing also allows a variety of shapes to be producedwithout use of a mold or other related device reducing the potential forcontamination and improving sterility. Such shapes may include forexample, an arrow head shape, rectangle, pyramidal, spherical,hemispherical, conical and others. 3-D printing methods also allow forrapid customization of the drug mass shape and size for individualpatient parameters, for example one or more of a patient's weight,medical condition and particular medical regimen (e.g. taking ofmedication once daily, twice etc.). In still other embodiments, 3-Dprinting methods can be used to produce shaped masses configured to havea bimodal form of delivery, e.g. fast release and slow release.

Other embodiments provide an inventory comprising a plurality of shapedmasses of a pharmaceutical composition comprising a drug such as apeptide, protein or immunoglobulin, wherein a property of the shapedmass, such as the biological activity of the drug after formation and/ordensity of the shaped mass, is maintained within a selected range forsubstantially the entire inventory. In use, such embodiments provide forthe ability to maintain uniform dosage and pharmacokinetic parametersfor one or more selected drugs delivered using embodiments of the shapedmasses described herein.

Further details of these and other embodiments and aspects of theinvention are described more fully below with reference to theaccompanying figures.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1a illustrates an embodiment of precursor materials for fabricatinga shaped mass.

FIG. 1b illustrates an embodiment of a shaped mass fabricated fromprecursor materials such as illustrated in FIG. 1 a, the shaped masshaving a cylindrical shape.

FIG. 2 is a perspective view showing an embodiment of the shaped masshaving a cubical shape.

FIG. 3 is a lateral view showing an embodiment of the shaped mass havinga hotdog/capsule like shape.

FIG. 4 is a perspective view showing an embodiment of the shaped masshaving a tablet shape.

FIG. 5 is a perspective view showing an embodiment of the shaped masshaving a spherical shape.

FIG. 6 is a lateral view showing an embodiment of the shaped mass havinga hemispherical shape.

FIG. 7 is a perspective view showing an embodiment of the shaped masshaving a pyramidal shape.

FIG. 8 is a perspective view showing an embodiment of the shaped masshaving an arrow-head shape.

FIG. 9 is a perspective view showing an embodiment of the shaped masshaving a conical shape.

FIG. 10 is a perspective view showing an embodiment of the shaped masshaving a rectangular shape.

DETAILED DESCRIPTION OF THE INVENTION

With reference now to FIGS. 1-10, various embodiments of the inventionprovide pharmaceutical compositions in the form of solid shaped masses10 comprising one more drugs and methods for forming solid shaped massescomprising one or more drugs. According to one or more embodiments, thedrug may comprise one or more polypeptides and proteins such as variousimmunoglobulins proteins (e.g. an antibody) which have a biologicalactivity (e.g. binding affinity for an antigen) which may be decreasedby conventional solid pharmaceutical formulation processes (e.g., suchas various compression processes used to form pills, tablets etc.) whichdegrade or otherwise damage the molecular structure of the protein orpeptide. FIG. 1a illustrates an example of precursor materials that maybe included in a solid shaped mass 10, including a therapeuticcomposition 20 which can include one or more drugs or other therapeuticagents 25, an excipient 30 and a degradable material 40 (such aspolyethylene, various sugars, lactic acid polymer, PGLG, etc.) whichdegrades within a target delivery site in the body (e.g., the wall ofthe small intestine) to release drug 25. One embodiment of the shapedmass 10 formed from precursor materials such as illustrated in FIG. 1ais the cylindrical shaped mass 10 illustrated in FIG. 1 b.

The shaped mass can 10 be formed from a variety of shaping processesknown in the pharmaceutical arts. Typically, the shaped mass will beformed by a compression process such as compression molding. The drugmay comprise a protein, peptide or antibody. According to one or moreembodiments, the biological activity of the protein or peptide in themass is at least about 70% to that prior to compression, morepreferably, at least 80% to that prior to compression, more preferably,at least 85% to that prior to compression, still more preferably about90% to that prior to compression and still more preferably at least 95%prior to compression (as used herein the term “about” means within 2%and more preferably within 1% of the stated value). These numbers mayalso correspond to a percentage (e.g. by weight) of the drug in theshaped mass relative to that prior to formation. In these and relatedembodiments, the shaped mass can have a density in a range of about 0.80to about 1.15 mg/mm³, more preferably in a range from about 0.90 toabout 1.10 mg/mm³, still more preferably in a range of about 1.02 to1.06 mg/mm³ and still more preferably in a range from about 1.03 to 1.05mg/mm³. The shape of the shaped mass will typically comprise a pelletshape but may also have a tablet, conical, pyramidal, hot dog/capsulelike, arrow head, cylindrical, cube, sphere, hemisphere or other likeshape as is shown in FIGS. 1-10. Also in these or alternativeembodiments, the particle size (e.g. diameter or widest dimension) ofthe powder used to make the shape mass 10 may be in the range of about50 to 450 μm, more preferably between about 100 to 400 μm and still morepreferably between about 200 to 400 μm with other ranges alsocontemplated. For embodiments of the shaped mass having a cylindrical orpellet shape, the shaped mass may have a diameter in the range fromabout 0.5 to 1 mm and a length from about 1.75 to 3.25 mm.

According to various embodiments, the shaped mass 10 can be formed inpart from a degradable material 30 that is configured to dissolve orotherwise degrade in the wall of the intestine such as the smallintestine (or another tissue site, e.g. an intramuscular site) so as torelease the drug into the intestinal wall where it diffuses or otherwiseis transported into the capillary bed of the intestinal wall and then iscarried by the circulatory system throughout the body. As used hereinthe term degrade includes one more of the processes of biodegradation,dissolving or disintegratation due to contact with a biological fluid(e.g., blood, interstitial fluid, lymph etc.) and/or tissue. Also theterms degrade and degradation can be used interchangeably. Suitabledegradable materials 30 include various sugars such as maltose andsucrose, various lactic acids polymers such as polyglycolic acid (PGA),polylactic acid (PLA); polyglycolic lactic acid (PGLA); variouspolyethylenes such as high density, low density and linear low densityPE and PEO (polyethylene oxide), various cellulose polymers such as HPMC(hydroxypropyl methyl cellulose), CMC (carboxy methyl cellulose), MC(methyl cellulose), methacrylic acid-ethyl acrylate copolymer,methacrylic acid-methyl methacrylate copolyme PVOH (polyvinyl alcohol),silicone rubber. and other biodegradable polymers known in the art. Thematerial and other properties of the degradable polymer and shaped masscan be selected to produce selectable rates of degradation in theintestinal wall. According to one or more embodiments, the rates ofdegradation can be selected to achieve various pharmacokineticparameters such as t_(max), C_(max), t½, etc. In one or more specificembodiments, the materials properties of the shaped mass (e.g. itschemical composition, solubility in interstitial fluids, size and shape)can be selected so as to have the shaped mass degrade within theintestinal wallto achieve a C_(max) for the selected drug(s) in ashorter time period than a time period to achieve a C_(max) for anextravascularly injected dose of the drug.

Embodiments of Methods For Fabricating Drug Containing Shaped Masses.

A description will now be provided of the fabrication process used tomake various embodiments of the drug containing shaped masses describedherein. The process includes a process for fabricating a powdercontaining one or more drugs and a shaped mass formation process forforming the powder into microtablets or other shaped masses comprisingone or more drugs. For ease of discussion, the shaped masses will now bereferred to as microtablets; however it should be appreciated that otherforms and/or shapes for the shaped masses are equally applicable (e.g.,pellet, cylindrical, hot dog like shape, etc)

Drug Powder Formation Process.

The process for formulation of a powder comprising the drug will now bedescribed. Typically, it includes three steps. The first step is toprepare an aqueous solution of the drug and then add the desiredexcipients 30 for the particular application. According to one or moreembodiments, excipients 30 can include one or more of a lubricant, abinder and a bulking agent. The lubricant is added to facilitate bothmicrotablet formation and ejection from a mold. The lubricant maycorrespond to polyethylene glycol 3350 and in one or more embodiments,may be added in proportion of approximately 10% w/w of the total batchmass. The bulking agent may correspond to mannitol and the binder maycorrespond to povidone. Other excipients which may be added includebinders, fillers, disintegrats, stabilizers, buffers and antimicrobials.The proportions of the different ingredients, active and non-active, inthe powder mixture are taken into consideration during the formulationprocess so as to achieve a desired therapeutic dose of the drug in theresulting microtablet.

The second step is to evaporate the aqueous mixture. The gently-mixedsolution containing the drug and the excipients is then placed in aflexible and flat plate (for example, silicone plate) inside of a vacuumchamber containing desiccant. The chamber is then placed inside of arefrigerator or cold room and is connected to a vacuum line or pump. Thesolution is left under vacuum and low temperature, above 0° C., until itdries out completely.

The third step comprises milling the evaporated mixture to produce afine powder. The evaporated mixture is placed in a low-protein-bindingtube along with a single high-density milling ball, preferably, made ofstainless steel or yttrium-stabilized zirconium. The milling is doneusing a rotator at max speed containing the tube film-wrapped to avoidmoisture absorption or contamination. An ice pack is desirably placed ontop of the tube to keep it cold. The room temperature can be controlledin a range for example from 60 to 64° F. The size of the milling tube,mass of the milling ball and duration of mixing may be selected toproduce particular powder grain sizes, grain size homogeneity and powderdensity. For example, for the production of a 40 mg to 100 mg batchcapacity, the use of a bottom-rounded 2 mL tube, a milling ball having a0.44 g mass and a milling duration of 3 hours resulted in fine andconsistent grain sizes, achieving more homogeneous and reliable densityvalues.

Microtablet Fabrication Process.

In various embodiments, the microtablet fabrication process is desirably(though not necessarily) done in a clean and temperature-controlled roomwhere the temperature is kept between 60-64° F. The microtabletformation process is typically done via compression using a compressionmold or other fixture to apply a compressive force to the powderincluding the drug. Two types of compression fixtures may be used, asemiautomatic one or a fully automatic version. For fabrication usingthe semiautomatic fixture, the microtablets are fabricated over a basewhich consists of two metal sheets connected to a force gauge stand byfour cylinders, four springs and four vibration mounting stoppers. Thetop sheet has a cavity with a hole on it for a mold or well to slide in.The mold used for the compression has a 45 degree funnel ending in awell with required diameter and length to accommodate the powder forcompression. A pin is attached to a pin holder and connected to theforce gauge which can be moved up and down by a controlled motoroperated by a 3-way switch.

The semiautomatic fabrication procedure can include the followingsteps: 1) positioning of a stopper, 2) placing a tablet mold on top ofthe stopper and a pin into the holder, 3) loading the powder requiredfor the microtablet and letting it sink/settle into the mold hole, 4)compressing the powder into the mold by advancing a motorized pin (whichis connected to force gauge) into the mold until a desired force isreach (i.e. compression force) and holding it in position with theapplied force for a set time period (i.e. hold time), 6) removing thetablet metal stopper and place a dish to collect the tablet, and 7)lowering the pin with the motor switch until the micro-tablet exits themold and collecting the microtablet in a dish. The combination ofcompression force and hold time will determine the mechanical structureof the microtablet as well as the decrease in the bioactivity of thedrug.

For the process using the automatic fixture, the processes of drugsinking, compression and ejection are fully automated. The mold rests ina base and is restrained by a mold holder by three screws. The moldbottom is in contact with a piece of metal referred to as a “gate” whichcan be move by the action of an air cylinder. The gate will stop thepowder from falling down during loading and compression and will openduring the ejection. An air cylinder is attached to the force gaugestand by a cylinder holder. This top air cylinder has a pin holderattached to its piston rod with a pin in it, which has the diameterrequired to be inserted into the mold hole and compress the powder. Ingeneral, a diameter of 0.0005″ less than the diameter of the mold holewould be enough to have a tight fit between pin and mold hole. The topair cylinder connected to the pin extends to produce the powdercompression and the ejection of the microtablet. A reed switch isconnected to this cylinder to know the position of the piston rod. Thestand also has a pneumatic vibrator with an air filter to vibrate thesystem and force the powder to move inside of the mold hole duringloading. The three pneumatic components, gate air cylinder,compression/ejection top air cylinder and vibrator, are controlled by anelectro-pneumatic system. This system consists of a power supply,programmable logic controller (PLC), four solenoids valves, reed switch,foot-switch pedal and a control panel that includes four regulators,four pressure gauges, micro-graphic panel and power switch.

In an automated embodiments for fabrication of the shaped mass, thecontrolling system may be built and programed in a way for the user tocomplete the following sequence: 1) user loads the powder; 2) userpresses the pedal for initiation and hold it until the end of thesequence; 3) vibration starts (vibration duration and pressure can bemodified at control panel); 4) powder is compressed by the pin due tothe extension of the top cylinder (compression duration and pressure canbe modified at control panel) followed by the retraction of the cylinderafter compression; 5) gate is opened by the retraction gate air cylinder(gate pressure can be modified at control panel as well as the time foropening and closing the gate); 6) the microtablet is ejected by the newextension of top air cylinder (ejection duration and pressure can bemodified at control panel) followed by the retraction of the cylinderafter ejection; finally 7) the gate closes ending the sequence.

After the micro-tablet is fabricated, the length, weight, density andbioactivity of the drug in the pellet are measured. The bioactivity ofthe drug in the micro-tablet may be assayed using an Enzyme-linkedimmunosorbent assay (ELISA) or other immune assay known in the art.

Embodiments of Shaped Masses Comprising Insulin.

According to one or more embodiments of the pharmaceutical compositionsdescribed herein, the drug contained in the microtablet or other shapedmass comprises insulin or like molecule for the treatment of diabetes orother glucose regulation disorder. The insulin may be obtained from anysuitable source e.g. human insulin and/or that generated usingrecombinant DNA methods known in the art. The specific dose of theinsulin contained in the mass can be selected based on one more of theweight, age and other parameter of the patient. In specific embodiments,the microtablet may comprise between about 0.2 to about 0.8 mg ofinsulin

In various embodiments, the shaped mass may be formed according to onemore methods described herein including compression formingmethods/processes such as those described in the examples. In these andrelated embodiments, the compression forming method is configured topreserve the biological activity of the insulin in the microtablet so asto be able to allow the drug to treat diabetes or other glucoseregulation disorder once released into the body of a patient. Thecompression force use in such compression methods may in the range ofabout 1.5 to 3 pounds of force. The weight percent of the insulin in themass can range from about 10 to 95%, more preferably from about 20 to95%, still more preferably from about 25 to 95% and still morepreferably from about 80 to 95%. The biological activity and/or weightpercentage of the insulin in the shaped mass may be in a range fromabout 88 to 99.8% to that prior to formation (e.g. from a powder use toform the microtablet). The density of the microtablet in suchembodiments can range from about 0.95 to about 1.15 mg/mm³, morepreferably from about 1.0 to about 1.10 mg/mm³. In preferredembodiments, the biological activity of the insulin in the shaped massmay comprise 99.2 to 99.8% of that prior to formation. The density ofthe microtablet in such embodiments can range from about 1.08 to 1.10mg/mm³. Measurement of the biological activity of the insulin in theshaped mass can be performed using assays known in the art, includingELISA or other immuno-assay methods.

According to one or more embodiments, the insulin containing shaped massmay also comprise one or more excipients including, for example, alubricant, a bulking agent and a binding agent or binder. The lubricantis selected to reduce the amount of force required to eject drugcontaining shaped masses from a mold and may correspond to polyethyleneglycol (PEG) an example including PEG 3350. The bulking agent maycorrespond to mannitol and the binder may correspond to povidone. Theweight percent of the insulin in the mass can range from about 10 to95%, more preferably from about 20 to 95%, still more preferably fromabout 25 to 95% and still more preferably from about 80 to 95%. Theweight percent of PEG can range from about 1 to 10% with a specificembodiment of 5%. The weight percent of Mannitol can range from about 4to 70% with a specific amount of 5%. The weight percent of Povidone canrange from about 1 to 5% with a specific embodiment of 1%.

Embodiments of Shaped Masses Comprising Incretin.

According to one or more embodiments of the pharmaceutical compositionsdescribed herein, the drug contained in the micro-tablet or other shapedmass comprises an incretin such as exenatide for the treatment of aglucose regulation disorder such as diabetes. Other incretins are alsocontemplated. The shaped mass may be formed according to one moremethods described herein including compression forming methods such asthose described in the examples for insulin. As described above forinsulin the compression forming method is configured to preserve thebiological activity of the incretin in the microtablet so as to be ableto allow the drug to treat diabetes or other glucose regulation disorderonce released into the body of a patient. The specific dose of theexenatide or other incretin contained in the mass can be selected basedon one more of the weight, age and other parameter of the patient. Inspecific embodiments, the microtablet may comprise between about 0.2 toabout 1 to 5 milligrams (mg) of exenatide. The density of the masscontaining the incretin can be in the range of 1.04±0.10 mg/mm³.

Embodiments of Shaped Masses Comprising TNF Inhibiting Antibody.

According to one or more embodiments of the pharmaceutical compositionsdescribed herein, the drug contained in the micro-tablet or other shapedmass comprises an antibody from the TNF (Tumor Necrosis Factor)inhibitor class of antibodies (e.g., adalimumab) for the treatment ofvarious autoimmune disorders (e.g. rheumatoid arthritis, etc) which arecharacterized by the over production of tissue necrosis factor. In theseand related embodiments, the compression and other aspects of theforming process used to fabricate the microtablet or other shaped massis configured to preserve the biological activity of the TNF inhibitingantibody so as to be able to treat one or more autoimmune disordersincluding but not limited to Rheumatoid arthritis, Psoriatic arthritis,ankylosing Crohn's disease, ulcerative colitis, plaque psoriasis andjuvenile idiopathic arthritis In specific embodiments, the TNFinhibiting antibody contained in the microtablet or other shaped massmay correspond to one or more of adalimumab (HUMIRA), infliximab(REMICADE), certolizumab pegol (CIMZIA) or golimumab (SIMPONI), oretanercept (ENBREL) to treat in therapeutic doses to treat one or moreof the aforementioned or other conditions.

As various embodiments of the shaped masses described herein compriseTNF antibodies, a brief discussion will now be presented on the TNFinhibitor class of antibodies, the conditions they treat and themechanism of treatment. Tumor necrosis factor (TNF, or TNF-α) is acytokine involved in systemic inflammation. The primary role of TNF isin the regulation of immune cells. TNF, being an endogenous pyrogen, isable to induce fever, to induce apoptotic cell death, to induce sepsis(through IL-1 & IL-6 production), to induce cachexia, induceinflammation, and to inhibit tumorigenesis and viral replication. TNFpromotes inflammatory response, which in turn causes many of theclinical problems associated with autoimmune disorders such asrheumatoid arthritis, spondylitis, Crohn's disease, psoriasis,hidradenitis suppurativa and refractory asthma. Antibodies that cantherapeutically achieve inhibition of TNF-α come under this TNF α (TumorNecrosis Factor α) inhibitor class of antibodies. All antibodiesincluding this TNFα inhibitory class of antibodies are characterized byhaving the structure of antibody, which is described as containing twofragments, Fab and Fc, joined together by disulphide bonds to form aY-shaped molecule. Examples for the TNFα inhibitory class of antibodiesinclude: Infliximab (Remicade) a mouse Fab-human Fc chimeric antibody(˜150 kda); Adalimumab (HUMIRA) ˜148 kda, a fully humanized antibody;Etanercept (Enbrel) 1-50 kda, p75 TNF-receptor domain-Fc (IgG1) fusionprotein; and Certolizumab pegol (Cimzia) which has human mab (Fab)linked to PEG. The most labile part of an antibody including the TNFαinhibitory class of antibodies is the disulphide bonds at the junctionof the Y-shape. As shown by the examples herein, the inventors havedemonstrated (by virtue of ELISA data showing that antibody moleculeremain structurally intact and retains its bioactivity) that thesedisulphide bonds are preserved for various antibodies incorporated intoa microtablet fabricated using the compression formation methodsdescribed herein. Therefore, one skilled in the art will appreciate thatembodiments of the compression formation methods described herein wouldbe expected to preserve the structure and bioactivity of antibody(including the TNF inhibitory class of antibodies) which has disulphidebonds at the junction of its Y-shaped molecule.

A description of the formation process for a microtablet or other shapedmass comprising adalimumab (herein HUMIRA), will now be provided;however it should be appreciated that this process is applicable to anyantibody and in particular to any antibody in the TNF inhibitory classof antibodies (e.g., infliximab or etanercept, etc.) or in the AI orAI17 class of antibodies. The compression force used to fabricate amicrotablet containing HUMIRA may in the range of 1.0 to 4 pounds offorce, with a specific embodiment of 3 lbs. The weight percent of theHUMIRA in the mass can be in a range from about 60 to 95%, morepreferably, from about 80 to 95%, with a specific embodiment of about95%. The biological activity of the HUMIRA in the shaped mass may be ina range from about 67 to 99% to that prior to formation (e.g. from apowder used to form the microtablet). The density of the microtablet insuch embodiments can range from about 0.86 to 1.05 mg/mm³, morepreferably from about 0.88 to about 1.03 mg/mm³. In preferredembodiments, the biological activity of the HUMIRA in the shaped massmay comprise 86 to 99% of that prior to formation. The density of themicrotablet in such embodiments can range from about 1.09 to 1.17mg/mm³. Measurement of the biological activity of the HUMIRA in theshaped mass can be performed using assays known in the art, includingELISA or other immuno-assay methods.

According to one or more embodiments, the HUMIRA containing shaped massmay also comprise one or more excipients 30 including, for example, alubricant, a bulking agent and a binding agent or binder. The lubricantis selected to reduce the amount of force required to eject drugcontaining shaped masses from a mold and may correspond to polyethyleneglycol (PEG) an example including PEG 3350. The bulking agent maycorrespond to mannitol and the binder may correspond to povidone. Theweight percent of PEG can range from about 1 to 15% with a specificembodiment of 10%. In various embodiments of the shaped masses used totreat immune conditions such as rheumatoid arthritis, the final dose ofHUMIRA in the shaped mass can be in a range of about 1 to 4 mgs, with aspecific embodiments of 1.3 mgs for a once a day daily dose so as tocorrespond to a monthly injected dose of 40 mgs.

Embodiments of Shaped Masses Comprising Anti-Interleukin Antibodies

According to various embodiments, the drug contained in the micro-tabletor other shaped mass comprise may comprise antibodies or other bindingproteins which attenuate the biological effects of one or more membersof the interleukin family by either binding to a particular interleukinor the receptors for that interleukin so as to prevent in either casethe interleukin from attaching to the receptor for that interleukin.Interleukins are a group of cytokines (both secreted proteins andsignaling molecules) which play an important role in the immune systemboth as signaling molecules and secreted proteins involved in thehumoral and cellular responses of the immune system. For the IL-17family of cytokines in particular, numerous immune regulatory functionshave been reported presumably due to their induction of many immunesignaling molecules. The most notable role of IL-17 is its involvementin inducing and mediating pro-inflammatory responses. IL-17 is commonlyassociated with allergic responses. IL-17 induces the production of manyother cytokines (such as IL-6, G-CSF, GM-CSF, IL-1β, TGF-β, TNF-α),chemokines (including IL-8, GRO-α, and MCP-1), and prostaglandins (e.g.,PGE2) from many cell types (fibroblasts, endothelial cells, epithelialcells, keratinocytes, and macrophages). The release of cytokines causesmany functions, such as airway remodeling, a characteristic of IL-17responses. The increased expression of chemokines attracts other cellsincluding neutrophils but not eosinophils. IL-17 function is alsoessential to a subset of CD4+ T-Cells called T helper 17 (Th17) cells.As a result of these roles, the IL-17 family has been linked to manyimmune/autoimmune related diseases including rheumatoid arthritis,psoriasis, psoriatic arthritis, inflammatory bowel disease, ulcerativecolitis, lupus, allograft rejection and anti-tumor immunity.

According to various embodiments, such anti-interleukin antibodiesherein, AI-antibodies, may correspond to a full-length antibody or anantigen-binding portion thereof. Also, they will typically though notnecessarily, comprise monoclonal antibodies which are human or humanizedantibodies using methods known in the art. As used herein, the term“antibody”, refers to any immunoglobulin (Ig) molecule comprised of fourpolypeptide chains, two heavy (H) chains and two light (L) chains, orany functional fragment, mutant, variant, or derivation thereof, whichretains the essential epitope binding features of an Ig molecule. Also,as used herein, “epitope” means a segment or feature of a proteincapable of specific binding to an antibody. Also, as used herein, an“anti-interleukin antibody (AI-antibody),” “AI-antibody portion,” or“AI-antibody fragment” and/or “AI-antibody variant” and the like includeany protein or peptide containing molecule that comprises at least aportion of an immunoglobulin molecule, including, but not limited to atleast one complementarity determining region (CDR) of a heavy or lightchain or a ligand binding portion thereof, a heavy chain or light chainvariable region, a heavy chain or light chain constant region, aframework region, or any portion thereof, or at least one portion of aninterleukin receptor (e.g. an IL-17 receptor) or binding protein, whichcan be incorporated into an antibody of the present invention. SuchAI-antibodies optionally further affect a specific ligand, such as butnot limited to where such an antibody modulates, decreases, increases,antagonizes, agonizes, mitigates, alleviates, blocks, inhibits,abrogates and/or interferes with at least one of a selected interleukins(e.g. IL-17a, IL-17b, etc.) activity or binding, or with IL-17 receptoractivity or binding, in vitro, in situ and/or in vivo.

In various embodiments, the AI-antibodies described herein andincorporated into one or more embodiments of the microtablets or othershaped masses may correspond to any one of the Interleukin 1-36 familyof interleukins along with their analogues and derivatives. In manyembodiments, the invention provides shaped masses including atherapeutic composition comprising antibodies or other binding proteinsto any one of the interleukin 1-36 family of interleukins (includingtheir analogues and derivatives) which can be delivered into the wall ofthe small intestine or other target tissue site. This can beaccomplished by incorporating or otherwise fabricating embodiments ofthe shaped mass into a biodegradable tissue penetrating member (e.g. inthe form of a dart or needle) that is configured to be advanced into thesmall intestine by the application of mechanical force and biodegrade torelease the IN-antibody into the intestinal wall and then thebloodstream. The tissue penetrating member may be contained anddelivered from a swallowable capsule that includes means for insertionof the tissue penetrating member into the wall of the small intestine orother wall in the intestinal tract. Further description of the tissuepenetrating member and swallowable capsule may be found in U.S. Pat.Nos. 8,721,620, 8,759,284 and U.S. patent application Ser. No.13/532,589 which are incorporated herein for all purposes.

In specific embodiments, the invention provides mircrotablets or othershaped masses comprising antibodies which bind to members of theinterleukin 17 family of antibodies, preferred examples includingSecukinumab and Ixekizumab; and antibodies which bind to the receptorfor the interleukin 17 family, a preferred example including Brodalumab,so as to prevent activation of the receptor by the antibody. Similar toTNF-antibodies these and other AI antibodies all have a disulphide bondsat the junction of their Y-shape which is the most labile part of theAI-antibody. As shown by the examples herein, the inventors havedemonstrated (by virtue ELISA data showing that antibody molecule remainstructurally intact and retains its bioactivity) that these disulphidebonds are preserved for various antibodies incorporated into amicrotablet fabricated using the compression formation methods describedherein. Therefore, one skilled in the art will appreciate thatembodiments of the compression formation methods described herein wouldbe expected to preserve the structure and bioactivity of these AI17 andother AI-antibodies. As such, particular embodiments of the inventionprovide shaped masses formed by compression or related method comprisingAI-antibodies wherein 75, 80, 85, 90, 95% or more of the biologicalactivity of the precursor AI-antibody material used to form the shapedmass is preserved in the final shaped mass.

AI-antibodies or other IN-protein provided by embodiments of the shapedmasses herein are particularly useful for treating a number ofautoimmune diseases and/or inflammatory conditions, including forexample rheumatoid arthritis, psoriasis, plaque psoriasis, juvenileidiopathic arthritis, psoriatic arthritis, ankylosing spondylitis,multiple sclerosis, Crohn's disease, inflammatory bowel disease andulcerative colitis. Such compositions result in the delivery ofAI-antibody with desirable pharmacokinetic properties in particularpharmacokinetic properties which are advantageous verses intravenous,sub-dermal or intramuscular injection. They also allow for the usage ofdosages which provide one or more of the following benefits includingreduced incidence of allergic reaction including anaphylactic shock; andreduced immunogenicity (verses subcutaneous and/or intramuscularinjection).

Anti-Interleukin-17 Antibodies

As discussed herein a number of embodiments of the invention provideshaped masses (e.g. microtablets, pellets, etc.) comprisingAI-antibodies (or other IB-proteins) for neutralizing or otherwiseinhibiting the biological effects of interleukins including those fromthe Interleukin 17 family of cytokines by preventing or modulating theability of the antibody to attach to its selected receptor. These shapedmasses may be configured to delivered to various target tissue sites inthe body into the wall of the small intestine or other target tissuesite in the intestinal tract. The targeted interleukin family ofinterleukin 17 antibodies include IL-17A, IL-17B, IL-17C, IL-17D, IL-17E(also called IL-25), and IL-17F. All members of the IL-17 family have asimilar protein structure, with four highly conserved cysteine residuescritical to their 3-dimensional shape, yet they have no sequencesimilarity to any other known cytokines. Numerous immune regulatoryfunctions have been reported for the IL-17 family of cytokines,presumably due to their induction of many immune signaling molecules.The most notable role of IL-17 family of cytokines (also referred to asIL-17) is its involvement in inducing and mediating pro-inflammatoryresponses. IL-17 is commonly associated with allergic responses. IL-17interleukins induce the production of many other cytokines (such asIL-6, G-CSF, GM-CSF, IL-1β, TGF-β, TNF-α), chemokines (including IL-8,GRO-α, and MCP-1), and prostaglandins (e.g., PGE2) from many cell types(fibroblasts, endothelial cells, epithelial cells, keratinocytes, andmacrophages). The release of cytokines causes many functions, such asairway remodeling, a characteristic of IL-17 responses. The increasedexpression of chemokines attracts other cells including neutrophils butnot eosinophils. IL-17 function is also essential to a subset of CD4⁺T-Cells called T helper 17 (Th17) cells.

Owing to the above roles, the IL-17 family of interleukins has beenlinked or otherwise associated with many immune/autoimmune relateddiseases including for example, rheumatoid arthritis, psoriaticarthritis, asthma, lupus, allograft rejection, anti-tumor immunity andrecently psoriasis and plaque psoriasis. In particular, increasedexpression of three of the IL-17 subtypes (A, C and F) has beenimplicated in the pathogenesis of inflammation in psoriasis.Accordingly, embodiments of the invention providing shaped masses havinga therapeutic composition comprising antibodies to one or more IL-17interleukins or receptors to the interleukin-17 family of interleukins,(herein Anti-IL-17 antibodies or AI17-antibodies) are useful fortreating one or more of these and other immune/autoimmune conditions.This is particularly the case for embodiments of the shaped masses thatare used to deliver the AI17-antibodies into the walls of the smallintestine (or other target site in the intestinal tract) as this allowsfor improved pharmacokinetics and reduced allergic and other adversereactions when the antibodies are delivered by IV, intramuscular orother form of injection. Again, the AI17-antibodies can be configured toattach to the interleukin itself or the receptor to the interleukin thuspreventing the receptor from being activated by the interleukin and inturn inhibiting otherwise attenuating the biologic effect of suchactivation. The inhibited or attenuated biological effects may includeone or more of the following: Th1 modulation; Th2 modulation (NakanishiK., et al. (2001) Cytokine and Growth Factor Rev. 12:53-72); and NKmodulation. Various embodiments of specific AI17-antibodies arediscussed in further detail below.

Secukinumab

Secukinumab is a human monoclonal antibody (mAb) that selectively bindsto and inhibits and/or neutralizes the activity of interleukin-17A(IL-17A) which has been implicated in a number of immune/autoimmunerelated conditions including plaque psoriasis. It is the first IL-17Ainhibitor approved by the FDA for the treatment of moderate-to-severeplaque psoriasis in adult patients who are candidates for systemictherapy. It has also shown positive clinical results for the treatmentof ankylosing spondylitis, psoriatic arthritis and is being evaluatedfor the treatment of mulitple sclerosis and rheumatoid arthritis.Accordingly, various embodiments of the invention contemplate thedelivery of shaped masses comprising therapeutically effective amountsof Secukinumab into the walls of the small intestine (or other targettissue site in the intestinal tract or other location) for the treatmentof one or more of the following conditions: psoriasis including plaquepsoriasis, ankylosing spondylitis, psoriatic arthritis, mulitplesclerosis, rheumatoid arthritis. The doses of Secukinumab for suchtreatment can be in a range from about 1-40 mg per day (which can bedelivered by means of the tissue penetrating member described hererin)with a specific dose range of about 20-40 mg per day for the treatmentof plaque psoriasis. For these and other dosages, the daily dose may beinitiated after a loading dose which may administired via injection(e.g. IV, intramusclar or subdermal) or other delivery method. The dosemay be titrated for an individual patient based on one or more of thepatient's, weight, age, severity of condition, amount of the loadingdose and treatment efficacy index known in the art for a givencondition, for example, Psoriasis Area and Severity Index (PAST) andInvestigator's Global Assessment modified 2011 (IGA) for the treatmentof plaque psoriasis. Further description of Secukinab includingformulations, doses and clinical uses may be found in U.S. patentapplication Ser. Nos. 13/876,367, 13/877,585 and 14/358,504 which areincorporated by reference herein in their entirety for all purposes.

Brodalumab

Brodalumab is a human monoclonal antibody (mAb) that binds with highaffinity to the receptor for and inhibits and/or neutralizes theactivity interleukin-of 17A (IL-17A) a molecule which, as indicatedabove, has been implicated in a number of immune/autoimmune relatedconditions including plaque psoriasis. Brodalumab is the onlyinvestigational treatment in development that binds to theinterleukin-17 (IL-17) receptor and inhibits inflammatory signaling byblocking the binding of several IL-17 cytokines (e.g. A, F and A/F) tothe receptor. As such, it would have efficacy for the treatment of anycondition involving the activation of one or more of these receptorsincluding without limitation, one or more of plaque psoriasis,ankylosing spondylitis, psoriatic arthritis, mulitple sclerosis,rheumatoid arthritis and inflammatory bowel disease. It has also shownpositive clinical results in a phase 3 study for the treatment of plaquepsoriasis. Accordingly, various embodiments contemplate the delivery ofshaped masses (e.g, microtablet) comprising therapeutically effectiveamounts of Brodalumab into the walls of the small intestine (or othertarget tissue site in the intestinal tract or other location) for thetreatment of one or more of the following conditions: psoriasisincluding plaque psoriasis, ankylosing spondylitis, psoriatic arthritismulitple sclerosis, rheumatoid arthritis, inflammatory bowel disease andother like conditions. The doses of Brodalumab for such treatment (whichcan be delivered by means of embodiments of the tissue penetratingmember described hererin) can be in a range from about 1-20 mg per daywith a specific dose range of about 9-14 mg per day for the treatment ofplaque psoriasis. For these and other dosages, the daily dose may beinitiated after a loading dose which may administered via injection orother delivery means. The dose may be titrated for an individual patientbased on one or more of the patient's, weight, age, severity ofcondition, amount of the loading dose and treatment efficacy index knownin the art for a given condition for example Psoriasis Area and SeverityIndex (PAST) and Investigator's Global Assessment modified 2011 (IGA)for the treatment of plaque psoriasis. Further description of Brodalumabincluding doses and clinical uses may be found in the paper by Coimbra,et al. entitled, “Brodalumab: an evidence-based review of its potentialin the treatment of moderate-to-severe psoriasis” Core Evid. 2014 Jul.21; 9:89-97 which is incorporated by reference herein for all purposes.

Ixekizumab

Ixekizumab is a human monoclonal antibody (mAb) that selectively bindsto and inhibits and/or neutralizes the activity of interleukin-17A(IL-17A) which has been implicated in a number of immune/autoimmunerelated conditions. It has also shown positive clinical results for thetreatment of psoriatic arthritis and plaque psoriasis. Accordingly,various embodiments contemplate the delivery of shaped masses comprisingtherapeutically effective amounts of Brodalumab Ixekizumab into thewalls of the small intestine (or other target tissue site in theintestinal tract or other location) for the treatment of one or more ofthe following conditions: psoriasis including plaque psoriasis,ankylosing spondylitis, psoriatic arthritis, mulitple sclerosis andrheumatoid arthritis. The doses of Ixekizumab for such treatment (whichcan be delivered by embodiments of the tissue penetrating memberdescribed hererin) can be in a range from about 1-40 mg per day (whichcan be delivered by means of one or more swallowable capsule or multiplecapsules given over the course of the day) with a specific dose range ofabout 2.5-5.5 mg per day for the treatment of psoriatic arthritis orplaque psoriasis. For these and other dosages, the daily dose may beinitiated after a loading dose which may administered via injection orother delivery means. The dose may be titrated for an individual patientbased on one or more of the patient's, weight, age, severity ofcondition, amount of the loading dose and treatment efficacy index knownin the art for a given condition for example Psoriasis Area and SeverityIndex (PAST) and Investigator's Global Assessment modified 2011 (IGA)for the treatment of plaque psoriasis. Further description of Ixekizumabincluding formulations, doses and clinical uses may be found in U.S.patent application Ser. No. 14/195,885 which is incorporated byreference herein in its entirety for all purposes.

Benefits of Delivery of AI17-Antibodies into the Intestinal Wall orOther Location in the Intestinal tract.

In use, embodiments of the invention providing for delivery ofSecukinumab, Broadulmab, Ixekizumab or other AI-antibody or IN-proteinby means of solid shaped masses into the wall of the small intestine (orother target site in the intestinal tract) for treatment of one or moreof immune/autoimmune conditions described herein or known in the medicalfield provide a number of benefits over injected forms ofAI-17-Antibodies (e.g., Secikinumab). These can include a highertherapeutic ratio, reduced incidence and severity of the adversereactions including one or more of: anaphylactic shock or other allergicreaction (including at the injection site); and nasopharyngitis, upperrespiratory tract infection, and headache (the latter three being notedfrom clinical studies for one or more of Secukinumab, Broadulmab, orIxekizumab) and decreased immungenicity and/or immunogenetic reaction.In the later case, such immunogenic reactions can result in thedevelopment in the patient of antibodies to the AI17 antibodiesthemselves resulting in reduced efficacy and the requirement of higherdoses of drug and/or an unwanted immune response. These benefits are dueto one or more of the following: i) the much smaller doses ofAI17-antibodies or (or other AI-antibody or IN-protein) that aredelivered by embodiments of the invention; ii) doses are delivered dailyvs weekly or monthly; and iii) the fact that doses are delivered orallyvs intravascularly.

In many embodiments, the therapeutic ratio of dosages of AI17-antibodiesdelivered orally by embodiments of the shaped masses can be increasedsignifciantly over that for AI17-antibody(s) delivered by injection(e.g., intravenously, intramuscularly, or subcutaneously, etc on aweekly, biweekly, or monthly basis). In various embodiments, the term“significantly” corresponds to an increase in the therapeutic ratio inan amout of two times or greater, e.g, seven to thirty times greater ormore. For AI17-antibodies or (or other AI-antibody or IN-protein) thatare typically delivered in weekly doses when injected (e.ginstravenously, intramuscularly, or subcutaneously, etc), thetherapeutic ratio (e.g Toxic Dose/Effective Dose) can be increased by afactor of seven when delivered in daily oral doses using embodiments ofthe shaped masses/tissue penetrating member described into the walls ofthe small intestine, while in the case of monthly injected doses of AI17antibodies the therapeutic ratio can be increased by a factor of 30 whendelivered daily oral doses by embodiments of the invention. Further,increases can be obtained when the oral dose of AI17-antibody is givenmultiple times over a day. Similar improvements (e.g by a factor of 7,30 or even more) can seen in the incidence in one or more ofimmunogenicity/immune response (vs intramuscular and/or subcutanousinjection), allegeric reaction, and other adverse reactions.Immunogenicity/immune response, being the production by the body ofantibodies to the administered to the AI17-antibody which neutralize orotherwise diminish the clinical efficacy of the AI17-antibody. Thereduction in the incidence of allergic reaction can be by a factor oftwo up to 30 due to the fact that the antibodies are given in dailydoses vs monthly doses which tends to desensitize the immune system (thedegree of allergic reaction can be determined using methods known in theart and may be correlated to one or more in vitro tests known in theart). Similarly, the degree of reduced immunogenicity and/or immuneresponse can be by a factor of two to as much as thirty or more duethree possible factors: 1) the doses are not delivered subcutaneouslyand/or intramuscularly (which tend to exacerbate such responses); 2) thedoses are delivered in much smaller amounts, e.g by a factor of 7 to asmusch as 30 depending on whether the injected dose is delivered weekly,biweekly, montly etc; and 3) as discussed above the dose AI-17 antibodyis delivered to the upper portions of the small intestine avoiding thepeyer's patches and subsequent production of immune cells and otherimmune response. The amount of immune response to a given AI17-antibody(e.g., Secukinumab) can be quantified using one more more immunologicanalytical methods known in the art to measure for example theproduction of generated antibodies to the delivered AI17-antibody orother AI-antibody. In particular embodiments, the dosage ofAI17-antibody can beconfigured to yield a minimal amount of antibodiesto the AI17-antibody in the patient, wherein minimal means less than 10%of the delivered AI17-antibodies are neutralized by the patient's ownantibodies and more preferrably less than 5%.

Embodiments of Shaped Massed Produced Using 3-D Printing.

Still other embodiments of the invention provide methods of preparing ashaped mass comprising a drug (which may comprise a protein orpolypeptide) wherein an outer coating(s) and/jacket of materials isformed over the drug using 3-D printing methods so as to form aselectively shaped micro-micro tablet or other shaped mass. The coatingor jacket may comprise one more biodegradable materials describedherein. According to one or more embodiments, the 3-D printing methodscan be configured to deposit the coating or jacket as a single layer oras a multilayer coating. In the latter case, different layers can beapplied which have different compositions, material properties, andthicknesses. In use, such multilayer applications allow for more precisecontrol of one or more properties of the shaped mass including forexample the rates of biodegradation of the shaped mass. For example,according to one embodiment, a relatively fast degrading layer can bedeposited over a drug layer, which is in turn positioned over a moreslowly degrading layer that in turn is positioned over a core mass ofdrug. In use, such embodiments can provide for a bio-modal form ofrelease with a rapid release (e.g., a bolus release) of drug under thefirst layer and a more slow release of drug under the second layer.

Use of 3-D printing methods allow the shaped mass to be formed withminimal or no pressure applied to the mass and in turn the underlyingdrug. In use, such methods improve the yield of the drug in the finalshaped mass due to decreased protein denaturation and/or otherdegradative effects on the drug. This in turn improves the bioactivityof the drug in the final shaped mass. Use of 3-printing also allows avariety of shapes to be produced without use of a mold or other relateddevice reducing the potential for contamination and improving sterility.Such shapes may include for example, an arrow head shape (e.g. theembodiment of FIG. 8.) rectangle, pyramidal, spherical, hemispherical,conical and others as is shown in FIGS. 1-10. 3D printing methods alsoallow for rapid customization of the drug mass shape and size forindividual patient parameters, for example, one or more of a patient'sweight, medical condition and particular medical regimen (e.g. taking ofmedication once day, twice etc.). In still other embodiments, 3-Dprinting methods can be used to produce shaped masses configured to havea bimodal form of delivery, e.g. fast release and slow release.

Embodiments of Inventories of Shaped Masses Having Uniform Properties.

Other embodiments of the invention provide an inventory of shaped massescomprising a drug such as a peptide, protein or immunoglobulin, whereina property of the shaped mass and/or the drug, such as the biologicalactivity of the drug post formation, is maintained within a selectedrange for substantially the entire inventory. In use, such embodiments,help to ensure the uniformity of one more of dosage, pharmacokineticparameters (e.g. t½, t_(max), C_(max), etc.) and resulting clinicaleffect for one or more selected drugs delivered using the shaped masses.For example, for embodiments of the shaped mass comprising insulin, thebiological activity and/or weight percentage of the insulin postformation can be maintained in a range of about 99.2 to 99.8% to thatprior to formation for substantially the entire inventory.

Routes of Delivery for the Shaped Masses. Embodiments of themicro-tablets or other shaped massed described herein, can be configuredto be used in combination with any suitable drug delivery system to beadministered via any appropriate route of administration. Such routes ofadministration can include without limitation, oral, sublingualparenteral, intravenous, intramuscular, subcutaneous, intra-ventricular,intra-cardiac, intra-cerebral. For example, according to one embodiment,insulin comprising micro-tablets can be taken orally and then have thedrug be absorbed through the wall of the small intestine or deliveredinto the wall small intestine. In the latter case, this can be doneusing a drug delivery device which includes a biodegradable tissuepenetrating member which contains or otherwise includes the microtablet.The tissue penetrating member may be advanced into the intestinal wallusing an advancement means such as an inflatable balloon which directlyor indirectly applies a force to the tissue penetrating member. In analternative or additional embodiment, the micro-tablet can be deliveredsubcutaneously to an intramuscular or other subcutaneous tissue site. Inspecific embodiments, the micro-pellet can be configured to dissolve ata selectable rate or rates to achieve a C_(max) or other desiredpharmacokinetic parameter (e.g. t_(max) etc.). Further, the compositionand properties of the micro-tablet can be configured have a dissolutionrate configured to achieve the desired C_(max) for the tissue at a givensite (e.g. in the wall of the small intestine, vs an intramuscularsite). In particular embodiments, the shaped mass can be inserted into acavity in the tissue penetrating member which is then sealed up. Thetissue penetrating member may comprise any number of biodegradablematerials such as maltose, sucrose or other sugar, PGLA (Polyglycoliclactic acid), polyethylene and others as is described in more detailabove.

EXAMPLES

Various embodiments of the invention are further illustrated withreference to the following examples. It should be appreciated that theseexamples are presented for purposes of illustration only and that theinvention is not to be limited to the information or the detailstherein.

Example 1: Micro-Tablets Comprising Human IgG and PEG

Materials. Pure human IgG (Alpha Diagnostics Intl. Inc, Cat#20007-1-100), Poly Ethylene Glycol 3350 (PEG, Sigma-Aldrich, Cat#P4338-500G), Water, molecular biology reagent grade (Sigma-Aldrich, Cat#W4502).

Methods. Human IgG and PEG 3350 in powder form were weighed out andmixed into a solution using molecular biology reagent grade water. Thepercentage of IgG and PEG are 90% and 10% respectively and the powderswere dissolved in water at 40 mg/ml concentration. Batches usingdifferent IgG mass capacity were prepared: 100 mg (batch 6 and 7), 140mg (batch 8) and 60 mg of IgG (batch 9). The aqueous solution was placedin a silicone plate and then evaporated in a vacuum chamber withdesiccant inside of a refrigerator for a minimum of 19 hours (batch 6, 7and 8) and up to 21 hours (batch 9) until full evaporation occurs. Datafor batches 1-5 are not included because these batches were trialbatches made using a different processes (e.g. different or no milling,evaporation, etc.) and micro-tablets were not fabricated for some ofthese batches as well.

The evaporated powder was collected into a low-bind conical 1.5 ml tube.Two small stainless steel balls (3.96 mm diameter, 0.5 g total mass) anda rotator (Roto-shake Genie) at max speed were used for milling. Themilling duration was 1.75 hrs (batches 6 and 7) and 1.5 hours (batches 8and 9). It was done at 64° F. room temperature with an ice packsurrounding the tube

Once the powder was milled, microtablets were fabricated using asemiautomatic molding fixture. The molding parameter included acompressive force of approximately 2.5 to about 3.5 lbs of force and acompression hold time of approximately 3 sec. Measurements were made ofthe amount of intact (e.g. biological active) IgG that was recovered inthe powder from before-milling, after-milling and and in the formedmicro-tablets. These measurements were made using IgG immunoassay (AlphaDiagnostics Inc.).

Micro-tableting includes the steps of processing of the powder recoveredfrom evaporation into fine homogenous powder and then forming it into asolid microtablet. The before-milling powder recovery is the startingpoint of the microtableting process and the percentage of IgG recoveredusing this manufacturing method was calculated by taking thebefore-milling protein recovery (e.g., the amount of biologicallyprotein active recovered in the powder prior to milling) to be 100%. Themicrotablet data and IgG recovery values are detailed in Table 1.Densities were measure by measuring the mass and volume of the tablet.Average density was found to be between 1.02 and 1.06 mg/mm³ while therecovery of intact and bioactive IgG found in the microtablets was equalor higher than 94.2% in average.

TABLE 1 Microtablet Data and IgG Recoveries for IgG MicrotabletsComprising 90% IgG and 10% PEG 3350 Absolute IgG Microtablet MicrotabletBatch Microtablet Microtablet Density IgG #* Length (mm) Weight (mg)(mg/mm³) Recovery 6 2.77 ± 0.07 1.16 ± 0.03 1.05 ± 0.01   87% ± 1.4% (N= 23) (N = 23) (N = 23)  (N = 10) 7 3.17 ± 0.15 1.33 ± 0.06 1.06 ± 0.0294.1% ± 0.9% (N = 15) (N = 15) (N = 15) (N = 5) 8 2.67 ± 0.09 1.11 ±0.03 1.06 ± 0.02 89.2% ± 3.2% (N = 15) (N = 15) (N = 15) (N = 5) 9 2.85± 0.09 1.15 ± 0.02 1.02 ± 0.02 77.8% ± 1.6% (N = 13) (N = 13) (N = 13)(N = 4)

Example 2: Micro-Tablets Comprising Human IgG PEG and Other Excipients

Materials. Pure human IgG (Alpha Diagnostics Intl. Inc, Cat#20007-1-100), Poly Ethylene Glycol 3350 (PEG, Sigma-Aldrich, Cat#P4338-500G), Water, molecular biology reagent grade (Sigma-Aldrich, Cat#W4502), sodium chloride (Sigma-Aldrich, Cat #59888), mannitol(Sigma-Aldrich, Cat #M8429-100G).

Methods. Human IgG was dissolved along with lubricant PEG 3350 andprincipal excipients in HUMIRA pen (sodium chloride and mannitol) in thesame percentage that in the pen solution. The powders were brought intosolution using 0.94 ml of molecular biology reagent grade water. Theevaporation process was done using the same procedure as used in a)above.

TABLE 2 Microtablet Data and IgG recoveries in IgG MicrotabletFormulation 67.8% IgG 7.5% PEG 3350 8.4% NaCl 16.3% Mannitol Total BallMicrotablet Microtablet Microtablet Absolute Milling Mass Length WeightDensity Microtablet IgG Batch # Ball (grams) (mm) (mg) (mg/mm³) IgGRecovery 7 1 S. Steel 0.438 3.23 ± 0.15 1.25 ± 0.07 0.97 ± 0.01 89.3%  (N = 8) (N = 8) (N = 8) (N = 2) 8 1 S. Steel 0.438  2.5 ± 0.21  1.1 ±0.07 1.12 ± 0.02 96% (N = 5) (N = 5) (N = 5) (N = 2) 9 1 0.4539 2.76 ±0.14 1.29 ± 0.05 1.18 ± 0.01 94% Zirconium (N = 5) (N = 5) (N = 5) (N =2)

The evaporated powder was then transferred to a low-bind round-bottom 2ml tube. The milling process was slightly different for each batch.Batches 7 and 8 were milled using stainless steel ball having a mass of0.438 with 3 hours of milling. Batch nine was made using a 9 anYttrium-stabilized zirconium ball having a mass of 0.454 with a millingduration of 3 hours. The rotation method and temperature conditions werekept as used in example 1). Note, data for batches 1-6 are not includedbecause they were made for milling optimization purposes only andmicro-tablets were not fabricated for these batches. Approximatemeasurements were made of particle grain sizes (diameter or widestdimension) for cases 7, 8 and 9 using a hemocytometer. Particle sizeranged from about 50 to about 450 μm for the three batches with specificdata of 100, 200, 200, 400 and 400 for batch 7; 50, 200, 300 and 400 forbatch 8; and 50, 100, 300 and 450 for Batch 9.

After milling, micro-tablets were fabricated using an automatic fixtureusing compression forces 2.6 lbs of compression force and a compressionholding time of 3 sec. The intact IgG recovered from the stages ofbefore-milling powder, after-milling powder and microtablets were testedusing an IgG immunoassay (Alpha Diagnostics Inc.). The microtablet dataand IgG recovery values are detailed in Table 2.

Definitions for terms used in Tables: The definitions for the terms usedin the tables below is provided below.

Absolute protein recovery after micro-tableting (APRAMT): This is thepercentage of active protein in the micro-tablet relative to that amountin the powder used to form the micro-tablet. It determined using anELISA assay of the selected protein in the micro-tablet. The formula forcalculation of this value is shown below APRAMT=(ELISA estimated proteincontent mass in the microtablet)/(total microtablet mass*protein masspercentage in total mass)

Example 3: Micro-Tablets Comprising HUMIRA and HUMIRA Pen Excipients

Materials. HUMIRA pens (Abbott Laboratories) and Poly Ethylene Glycol3350 (PEG, Sigma-Aldrich, Cat #P4338-500G).

Methods. The solution contained in the HUMIRA pen was placed in alow-bind 1.5 ml tube where PEG 3350 amount was added and mixed withHUMIRA ingredients. The solution was evaporated following the sameconditions as the ones described in example 1 a) and b).

The milling conditions were the same as in example 1 a) where two ballswere used with total mass of 0.5 grams and 1.5 hours (batch 1, 2 and 4)and 1.75 hours (batch 3) of milling duration. The same temperatureconditions were kept as in example 1.

After powder milling, microtablets were formed by using a semiautomaticfixture using approx. 3 lbs. of force for compression and a holdingcompression time of approx. 3 sec. The intact HUMIRA recovered inbefore-milling powder, after-milling powder and microtablets were testedusing an HUMIRA immunoassay (Alpha Diagnostics Inc.). As in example 1),the before-milling powder recovery is the starting point of themicrotableting process and the percentage of HUMIRA recovered using thismanufacturing method was calculated using the before-milling powderrecovery as 100%. The microtablet data and HUMIRA recovery values aredetailed in Table 3.

The average density ranged from about 0.88 up to about 1.05 mg/mm³ andthe amount of bioactive HUMIRA recovered in the microtablets ranged fromabout 67 to about 80% to that prior to formation of the microtablet.

TABLE 3 Microtablet Data and Adalimumab recoveries in AdalimumabMicrotablet Formulation: 90% HUMIRA Preparation (Drug and Excipients)from HUMIRA Pen Absolute Adalimumab PEG Microtablet MicrotabletMicrotablet Amount added Length Microtablet Density Adalimumab Batch(mg) (mg) (mm) Weight (mg) (mg/mm³) Recovery 1 40 4.4 3.28 ± 1.33 ± 0.051.03 ± 0.02 79.3% ± 0.16 (N = 19) (N = 19) 2.3% (N = 19) (N = 6) 2 404.4 4.12 ± 1.56 ± 0.08 0.96 ± 0.03   74% 0.17 (N = 13) (N = 13) (N = 2)(N = 13) 3 40 4.4 3.15 ± 1.22 ± 0.02 0.98 ± 0.01 66.7% 0.03 (N = 23) (N= 23) (N = 2) (N = 23) 4 48 5.3 3.25 ± 0.1 1.13 ± 0.04 0.88 ± 0.02 76.2%± (N = 23) (N = 23) (N = 23) 2% (N = 9)

Example 4: Micro-Tablets Comprising Insulin-Biotin Complex

Materials. Biotin-Human Insulin solution (Alpha Diagnostics, cat#INSL16-BTN-B) and Poly Ethylene Glycol 3350 (PEG, Spectrum, Cat#P0125-500G).

Methods. Biotinylated insulin (insulin with an attached biotin molecule)was purchased from Alpha Diagnostics and received in a liquid formcontaining 2 mg/ml Insulin in 1×PBS (12 mM KPO4, 2.7 mM KCl, and 137 mMNaCl, pH 7.4). Ovalbumin was added to the solution at 1% by supplier.The solution purchased was placed in a low-bind 1.5 ml tube where PEG3350 was added and mixed and mixed into the solution. The constituencyof the final formulation for bathes 4-7 was the following: 8.7%biotin-human insulin complex, 5% PEG 3350, 43.5% Ovalbumin and 42.7%salts from 1×PBS during dialysis. Note batches, 1-3, were not includedhere due to large difference in the excipients amounts from batches 4-5.The solution was evaporated following the same conditions as the onesdescribed in example 1.

Once the powder was fully dry, it was then transferred to a low-bindround-bottom 2 ml tube. The milling process used a singleYttrium-stabilized zirconium ball having a mass of 0.445 g for durationof 1.5 hours. The rotation method and temperature conditions were thesame as used in Example 1.

After milling, microtablets were fabricated using an automatic fixtureusing 26 psi air pressure for compression, resulting in a compressionforce of about 1.8 lbs, and using a holding compression time of 3 sec.The air pressure for ejection was set at 28 psi (˜1.82 lbs ejectionforce). The Biotin-Human Insulin microtablets were tested using anInsulin-biotin ELISA immunoassay kit (Alpha Diagnostics Inc., Cat#0030-20-1). The microtablet data and Biotin-Human Insulin recoveryvalues are listed in Table 4.

TABLE 4 Microtablet Data and Biotin-Human Insulin Complex Recovery DataFormulation 8.7% Biotin- Human Insulin 5% PEG 43.5% 42.7% Salts from 1XComplex 3350 Ovalbumin PBS during dialysis Microtablet MicrotabletMicrotablet Absolute Microtablet Batch Length (mm) Weight (mg) Density(mg/mm³) Insulin Recovery 4  3.4 ± 0.07 1.35 ± 0.08   1 ± 0.05 94.2% ±3.6% (N = 4) (N = 4) (N = 4) (N = 3) 5 3.78 ± 0.04 1.35 ± 0.02 0.9 ±0.01 69.9% ± 2.3% (N = 5) (N = 5) (N = 5) (N = 3)

Example 5: Micro-Tablets Comprising Insulin

Materials. Human Insulin (Imgenex, cat #IMR-232-250), Poly EthyleneGlycol 3350 (PEG, Spectrum, Cat #P0125-500G), Mannitol (Amresco, Cat#0122-500G), Povidone (ISP-Technologies, Plasdone C-30) and sterilewater (APP Pharmaceutical, Cat #918510).

Methods. Human insulin was mixed in solution with different excipientsproducing various batches for analysis. The formulation of each batch isdetailed in Table 5. Batches 1-A, 2, 3B and 6B were not included due todifferent fabrication parameters. The excipients included PEG 3350(lubricant), Mannitol (bulking agent) and Povidone (binder). Theseexcipients and the API (human insulin) were dissolved in sterile water.The solution was evaporated using the same conditions as the onesdescribed in example 1.

The milling process and parameters were the same as in example 4, usinga low-bind round-bottom 2 ml tube and a single Yttrium-stabilizedzirconium ball (mass of approx. 0.45 g) for duration of 1.5 hours. Therotation method and temperature conditions were kept as used in Example1.

After milling, microtablets were fabricated using an automatic fixturewith 74.5 psi air pressure used for compression (resulting in acompression force of about 2.6 lbs) and a holding compression time of 3sec. The air pressure for ejection was set at 80 psi (˜2.7 lbs ejectionforce) The human Insulin microtablets were tested using Human InsulinELISA immunoassay kit (Alpha Diagnostics Inc., Cat #0030N). Themicrotablet data and Human Insulin recovery values are detailed in Table6.

TABLE 5 Formulation for Human Insulin Microtablets (weight %) * HumanPEG Batch Insulin 3350 Mannitol Povidone 1B 25.8%  5% 69.2%  — 3A 23% 5%72% — 4 89% 5%  6% — 5 89% 5%  4% 2% 6A 80% 5% 13% 2% 7 80% 5% 13% 2% *Note, the formulation are listed for Insulin batches 1b-7 because thecomposition in these batches changed batch to batch, they did not do sofor other batches.

TABLE 6 Microtablet Data and Human Insulin Recovery Data AbsoluteMicrotablet Microtablet Microtablet Microtablet Density Insulin BatchLength (mm) Weight (mg) (mg/mm³) Recovery 1B  2.1 ± 0.03  0.9 ± 0.011.08 ± 0.01 87.5% ± 0.8%  (N = 22) (N = 22) (N = 22) (N = 5) 3A 2.32 ±0.07 0.93 ± 0.02 1.01 ± 0.01 96.6% ± 2.6% (N = 6) (N = 6)  (N = 6)  (N =3) 4 2.42 ± 0.11 0.97 ± 0.04 1.01 ± 0.01 81.1% ± 3.1% (N = 5) (N = 5) (N = 5)  (N = 3) 5 2.42 ± 0.07 0.95 ± 0.02 0.99 ± 0.02 97.6% ± 1.6% (N =9) (N = 9)  (N = 9)  (N = 6) 6A 1.95 ± 0.03 0.86 ± 0.01 1.12 ± 0.0194.8% ± 3.5% (N = 15) (N = 15) (N = 15) (N = 3) 7 2.09 ± 0.02 0.91 ±0.01 1.09 ± 0.01 99.5% ± 0.3% (N = 82) (N = 82) (N = 82)  (N = 16)

CONCLUSION

The foregoing description of various embodiments of the invention hasbeen presented for purposes of illustration and description. It is notintended to limit the invention to the precise forms disclosed. Manymodifications, variations and refinements will be apparent topractitioners skilled in the art.

Elements, characteristics, or acts from one embodiment can be readilyrecombined or substituted with one or more elements, characteristics oracts from other embodiments to form numerous additional embodimentswithin the scope of the invention. Moreover, elements that are shown ordescribed as being combined with other elements, can, in variousembodiments, exist as stand-alone elements. Further, various embodimentsexpressly contemplate the negative recitation of any element that shownor described in one or more embodiments. Hence, the scope of the presentinvention is not limited to the specifics of the described embodiments,but is instead limited solely by the appended claims.

What is claimed is:
 1. A shaped mass comprising exenatide for treatmentof diabetes or other glucose regulation disorder, wherein a weightpercentage of exenatide in the shaped mass is at least about 60%, andwherein at least about 80% of the exenatide in the shaped mass isbiologically active, the shaped mass having a density in a range ofabout 0.95 to about 1.15 mg/mm³, wherein the shaped mass furthercomprises an excipient.
 2. The shaped mass of claim 1, wherein a weightpercentage of exenatide in the shaped mass is in a range of about 80 to95%.
 3. The shaped mass of claim 1, wherein the shaped mass comprisesbetween about 1 to 5 mg of exenatide.
 4. The shaped mass of claim 1,wherein the shaped mass has a cylindrical shape.
 5. The shaped mass ofclaim 1, wherein the shaped mass has a tablet or pellet shape.
 6. Theshaped mass of claim 1, wherein the shaped mass has a tissue penetratingshape.
 7. The shaped mass of claim 1, wherein the shaped mass comprisesa biodegradable material which breaks down in intestinal wall tissue soas to release the exenatide.
 8. The shaped mass of claim 1, wherein theexcipient comprises PEG.
 9. The shaped mass of claim 1, wherein theexcipient comprises at least one of a lubricant, a binding agent or abulking agent.
 10. The shaped mass of claim 9, wherein the binding agentis povidone.
 11. The shaped mass of claim 9, wherein the bulking agentis mannitol.
 12. The shaped mass of claim 9, wherein the lubricant isPEG.
 13. The shaped mass of claim 9, wherein the lubricant is PEG, thebulking agent is mannitol, and the binder is povidone.